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Testosterone and Lifestyle

I am often asked what supplements to take to offset the decline in testosterone with age. “None,” is my answer. “The best thing you can do is eat a healthy diet, control your bodyweight, and exercise.” I’ve long believed that--and now there’s a study that suggests I’m on the right track. Thomas G. Travison, PhD, and his colleagues at New England Research Institutes, Watertown, Massachusetts observed 1667 Boston-area middle-aged men (40 to 70 at baseline) for 15 years to determine the relative impact of aging, health and lifestyle on male testosterone levels. The results were first published online December 5, 2006 in The Journal of Clinical Endocrinology & Metabolism. (Thanks to my friend Richard Winett, PhD, for alerting me to the study in his Master Trainer newsletter.) 

As related in our June 2007 Update (article 191, Fitness & Health), recent testing at the Cooper Clinic, at age 69, found my serum testosterone to be 479. The normal range is 241-827, so I’m about in the middle. There has been essentially no change in the last 7 years. In 2000, the Cooper Clinic measured my testosterone at 483. I don’t know what my level was when I was younger, but there is no reason to believe I’ve suffered any precipitous decline. I’ve had no chronic illnesses and my body composition has been basically unchanged. I believe my lifestyle plays a major role in my apparently stable testosterone level. Let’s see what the study found. 

At the beginning of the study in 1987-89, testosterone levels were determined for all participants. In addition, each person was questioned about their health status, medications taken and lifestyle (smoking, alcohol, physical activity, diet, marital status, etc). Body mass index (BMI) was also recorded. Follow-up assessment and testing was done at 9 and 15 years.

According to the researchers, testosterone levels are known to gradually decline with age, but there is little consensus on what is normal for healthy aging men. We do know that low testosterone contributes to “diabetes and prediabetic conditions, reduced bone and muscle mass, impaired sexual function, and decreased quality of life.” Abnormally low testosterone can be a problem. “It is unclear, however, whether declines in T are primarily associated with normal aging per se or rather with age-related changes in overall health and lifestyle.” In other words, we don’t know how much decline is an inevitable result of aging and how much may be preventable through lifestyle and other health measures. Here’s what they found. 

Overall, a “roughly linear” decline in T was found with age. Importantly, however, the researchers “observed consistent evidence that acceleration in within-subject declines in T levels were associated with contemporary changes in health and lifestyle.” For example, subjects with no chronic illnesses during the first 9 years experienced on average a 7.3% decline in T, while those who developed one or more illnesses over the same period showed a 13.1% decline. More significantly in terms of controllable factors, a 4 to 5 increase in BMI, moving from non-obese to obese, “was associated with declines in total serum T comparable to that associated with approximately 10 yr. of aging.” Loss of a spouse was also associated with a decline equivalent to 10 years of aging.  

Controlling for all other variables, the decline in total testosterone associated with aging was found to be roughly 10% per decade. The researchers say this figure is comparable to estimates for healthy men reported in other studies.

“The results presented here suggest that although hormone declines appear to be an integral aspect of the aging process, rapid declines need not be dismissed as inevitable,” the researcher conclude. “These results suggest the possibility that age-related hormone decline may be decelerated through the management of health and lifestyle factors.”

I'm going to continue urging men concerned about decline in testosterone to forget about supplements and focus on eating a healthy diet, controlling bodyweight, and exercise. Keep in mind that the participants in this study were picked at random from male residents of greater Boston. They are by no means representative of people, like many visitors to this site, who work every day to optimize their health and fitness.

What about HRT?

Okay, but what about helping things along with hormone replacement therapy? I discourage taking hormones unless the person has a testosterone deficiency and their doctor recommends HRT. Another group of scientists at New England Research Institutes, led by Beth A. Mohr, working with data from the same study we've been discussing (the Massachusetts Male Aging Study), proposed age-specific thresholds for abnormally low total T: 251, 216, 196 and 156, for men in their 40s, 50s, and 60s and 70s, respectively. (Clinical Endocrinology, Volume 62 (1), 64-73, January 2, 2005)

I’m well above those levels, and most of the men I hear from probably are as well. I would think long and hard before embarking on a regimen of HRT. “We just can’t predict all the potential harmful effects of taking hormones even though on the surface they may seem beneficial,” says Todd Nippoldt, MD, Mayo Clinic Rochester. For important details, read “Testosterone therapy: The answer for aging men?” http://www.mayoclinic.com/health/testosterone-therapy/MC00030   

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